Citation

Klein AP, Tetzlaff JE, Bonis JM, Nelson LD, Mayer A, Huber DL, Harezlak J, Mathews VP, Ulmer JL, Sinson GP, Nencka AS, Koch KM, Wu YC, Saykin AJ, Difiori JP, Giza CC, Goldman J, Guskiewicz KK, Mihalik J, Duma SM, Rowson S, Brooks A, Broglio SP, McAllister T, McCrea M, Meier T. J. Neurotrauma 2019; 36(11): 1776-1785.

Affiliation

Medical College of Wisconsin, Neurosurgery , 8701 Watertown Plank Road , Milwaukee, Wisconsin, United States , 53226 ; tmeier@mcw.edu.

Copyright

(Copyright © 2019, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2018.6055

PMID

30618331

Abstract

Previous studies have shown that mild traumatic brain injury (mTBI) can cause abnormalities in clinically relevant MRI sequences. No large-scale study, however, has prospectively assessed this in athletes with sport-related concussion (SRC). The goal of the current study was to characterize and compare the prevalence of acute, trauma-related MRI findings and clinically significant, non-specific MRI findings in athletes with and without SRC. College and high-school athletes were prospectively enrolled and participated in scanning sessions between January 2015 through August 2017. Concussed contact sport athletes (n=138, 14 F, 19.51.6 years) completed up to four scanning sessions following SRC. Non-concussed contact (n=135, 15 F, 19.71.6) and non-contact athletes (n=96, 15 F, 20.01.7) completed similar scanning sessions and served as controls. Board certified neuroradiologists, blinded to SRC status, reviewed T1-weighted, T2-weighted Fluid Attenuated Inversion Recovery (FLAIR), T2*-weighted, and T2-weighted images for acute (i.e., injury-related) or non-acute findings that prompted recommendation for clinical follow-up. Concussed athletes were more likely to have MRI findings relative to contact (30.4% vs. 15.6%, OR=2.32, p=0.01) and non-contact control athletes (19.8%, OR=2.11, p=0.04). Female athletes were more likely to have MRI findings than males (43.2% vs. 19.4%, OR=2.62, p=0.01). One athlete with SRC had an acute, injury-related finding; group differences were largely driven by increased rate of non-specific white matter hyperintensities in concussed athletes. This prospective, large-scale study demonstrates that <1% of SRCs are associated with acute injury findings on qualitative structural MRI, providing empirical support for clinical guidelines that do not recommend use of MRI following SRC.

Language: en

Keywords

HUMAN STUDIES; MRI; TRAUMATIC BRAIN INJURY